To the Editor.
—Several authors have recently described their techniques for implanting posterior chamber intraocular lenses at the time of keratoplasty.1-4 Since I studied the original report by Hall and Muenzler,1 I have inserted posterior chamber lenses at the time of keratoplasty in nine patients with known or suspected anterior chamber angle compromise. My technique, derived from Hall and Muenzler, consists of suturing a four-hole optic lens to the iris with two double-armed 10-0 polypropylene sutures. Each suture passes through a pair of positioning holes and incorporates the overlying iris.For optic fixation, I believe that a four-hole optic provides distinct advantages over a two-hole optic. With the latter, only the small optic portion between the hole and optic edge is incorporated in the suture; therefore, only the small overlying iris segment can be used for lens fixation. The four-hole optic permits the surgeon to incorporate a broader
Koch DD. New Optic Hole Configuration for Iris Fixation of Posterior Chamber Lenses. Arch Ophthalmol. 1988;106(2):163–164. doi:10.1001/archopht.1988.01060130173003